Egg collection was a half hour late

[xylophone]

Hello,

I'm looking for people's thoughts on what has happened with our IVF as I'm not sure what to think. Any opinions and experiences would be very welcome.

In a nutshell, at my final scan there were only 6 big enough for collection, some were very big so they said I was 'definitely ready'. The trigger shot was Buserelin / Suprecur. They made a big thing about taking it at exactly the right time (10:30pm) because it should be 36 hours before egg collection. On day of egg collection I was feeling very uncomfortable and sore. We were asked to be at the clinic at 10am for 10:30am egg collection. At 10:35 we were still in the waiting room. Eventually they fetched me and I was being sedated at 11am.

Unfortunately only 4 follicles were seen during surgery and only 2 eggs collected from those. So disappointing. The embryologist said it's possible that we missed the 2 biggest follicles but didn't want to speculate further.

I'm now wondering (amongst lots of things!) whether the delay in the egg collection surgery could have contributed to us missing the eggs. I've done some googling but can't find any other people's experiences of being taken into surgery late. This was a private clinic, if it makes any difference, and the only shot at IVF that we can afford. I'm not usually one to complain but I am wondering if this has affected the success.
Many thanks if you've read this far!

I have no idea but just wanted to say my egg collection was also pushed back half an hour and it didn't seem to effect my results. You should try and speak more to the embryologist

Thank you Elsaesmerelda, that is helpful to hear.

One more thing, I had one follicle that was measuring really big and I was originally meant to do a double trigger but they told me to only do the normal dose as apparently this would cause the egg to detach too soon. Just a thought maybe you could ask if it could have been anything to do with your trigger shot

Thank you, I'll definitely ask about if I get a chance. They didn't discuss the trigger at all beforehand so I'm not sure whether what i took (50 iu buserelin) was a single or double trigger. Thanks for taking the time to reply, I feel a bit lost in this process.

30 minutes wouldn't make much of a difference at all - it's not that tight a window for collection. Also the trigger shots aren't about preventing premature ovulation they basically make the egg easy to get the egg out of the follicle and also mature them (reducing the 46 chromosomes to 23)

How big were your follicles when they last measured them as that will be more important? Most clinics like them around 17-22mm - much bigger than that they could spontaneously ovulate but you should also have been on an injection like cetrotide which keeps LH hormone low which is the hormone that signals the follicle to release the egg

My clinic work on 38 hours rather than 36 and I was 10 mins late going in so I wouldn’t have thought it would have affected the outcome for you.

Thank you both for your thoughts, they're really helpful. MF1981 that's really interesting about your clinic doing 38 hours. I wonder if depends on the trigger shot used?

Ivfbeenbusy interesting questions, thanks. At my last scan (Monday morning) I had a couple of follicles at 24mm already, so pretty big. Trigger was Monday night and then egg collection was on Wednesday. I'm wondering if I spontaneously ovulated them those before the procedure because they were so big. I was on Menopur for stims from Day 1 and Fyremadel from Day 6 (to prevent ovulation I think?)

I am reading about other women having blood tests to check LH levels but I didn't have any blood tests during the cycle.

It sounds like the half hour delay is unlikely to have made a difference. Maybe I'm just looking for something to blame in order to understand why we went from an AFC of 16 to 2 eggs :(

@xylophone

It's Unusual not to have any blood tests to check LH levels - I wouldn't be very happy with that? Is this an NHS clinic? Mine were checked every 48 hours and sometimes daily during stimming x

Sorry to jump in @ivfbeenbusy but my bloods wasn't checked once either and this was private with care. I did expect them too from what I'd been reading on here, is this not the norm then?

Thanks for your insight on this Ivfbeenbusy and elsaesmerelda. It was a private clinic in London, our one shot at private IVF. I was a bit surprised at the lack of blood tests but they were never mentioned so assumed they weren't necessary. This was short protocol IVF, not sure if that makes a difference.

@xylophone @elsaesmeralda

I've done 5 rounds of IVF and it was standard to test whether you were on short protocol or natural modified (I was with Create) - they use it to monitor e2 levels to ensure follicle growth is in line with hormone levels (to catch any signs of either OHSS or poor egg quality - I had cycles abandoned before when lots of follicles were seen on the scan but e2 levels were low suggesting lack of maturity.) it also monitors LH levels to ensure you start drugs to prevent ovulation early enough

@ivfbeenbusy thanks for the info! hmm that's interesting then I wonder why it wasn't done?!

Hi @xylophone My collection was getting on for an hour late. It really concerned me initially, but the staff weren't worried at all, so this reassured me. Maybe speak to them if you have concerns though, you'd certainly have every right to question it if you feel it may have affected the outcome, and peace of mind is important for you too. I never had bloods taken during my cycle either, only beforehand, so it mustn't be standard for everybody/clinic. Good luck.

@elsaesmeralda

Sorry to jump in *@ivfbeenbusy* but my bloods wasn't checked once either and this was private with care. I did expect them too from what I'd been reading on here, is this not the norm then?

I've never had my bloods tested either for egg collection; I've had two, both private.

Sorry you didn't get as many eggs as you were hoping op, that must be very upsetting. Do ask your clinic about it. Your follicles were quite big on the Monday so maybe two did ovulate early - I am just speculating though.

Ahh good to hear others haven't had bloods either was starting to worry something might be a bit dodge 🤔

EllieEskimo and seven201 thank you for both of your kind messages and for sharing your experiences. It's really helpful. I think I do need to talk to the clinic about what happened, although I find the doctor to be a woman of very few words so I'm not sure I'll get answers.

I wasn't getting my hopes up a lot but 2 eggs is disappointing when I was told my AMH and AFC were both fairly good. Happily both have fertilised but I'm not really expecting to end up with any embryos after 5 days. Ah well.

I'm sorry to hear about your experience and can imagine you have a lot of questions. I would also ask about your trigger shot. For most women a trigger shot of between 7.500 or 10.000 hcg is most effective for the maturation of eggs (brands are for example ovitrelle or gonasi). If a woman is at high risk of Ohss and has 15+ follicles (also depending on AMH) something like burserelin (GnRH) is used as a trigger. It's much milder and prevents overstimulation. At the moment due to Covid some clinics use GnRH for all women to avoid Ohss and putting pressure on the NHS. I'm not a medical professional at all- I've just have done a lot of research on this area because I once had a complete failure of fertilisation round- but from what you say I would suggest that you ask your clinic if the trigger for simply not high enough. Good luck xxx

I'm Surprised how many people on this thread didn't have any blood test monitoring - I just assumed all private clinics did it as standard (except ABC which is a no frills service)

Don't be disheartened about your 2 eggs - my most successful cycle out of 5 and the ones which made my twins is the one where I had the lowest number of eggs out of all my egg collections and I only had 2 eggs x

Sorry for taking a while to come back to this as the weekend has been a bit hectic, I really appreciate every response.

Matilda128 this is really interesting, thank you, I had no idea why different trigger shots are used so this is all learning for me. I'm not at high risk of OHSS so I'll definitely bring this up with the clinic, thank you. We can't afford to go again sadly but I do want to understand what happened.

ivfbeenbusy Thank you for this, your 2 egg success story has made me feel a bit more hopeful. I'll find out tomorrow whether either of them have made it to day 5. Thank you for raising the blood test question, I'll try to ask the clinic about this to understand more about why some people are monitored and some aren't and if I learn anything I'll update the thread!